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DOI: 10.18502/kls.v4i10.3768

Abstract

The Government has determined exclusive breastfeeding from birth to six months but some women are not exclusively breastfeeding baby until six months of age. The time for work outside home takes up to more than eight hours is one of many factors that cause the mother didn't give exclusive breastfeeding. The goal of this study is to examine the relation between the working time of mother with the success of exclusive breastfeeding in Bergas Lor village, Bourgas district. The design of this research used correlative study with cross-sectional approach. The samples were all working mothers who have children from 7 to 12 months in February 2013 and 43 mothers became samples by using purposive sampling, and data collecting used questionnaires. The data analysis used Chi-Square test. The result showed from 43 surveyed respondents, 28 mothers (65.1%) worked more than 8 hours/day, and 30 mothers (69.8%) didn't get successful to give exclusive breastfeeding. The conclusion of the Chi-Square test based on Yates' Continuity Correction gets X2 value 4.268 with p-value 0.039. Because of p-value < α (0.05), Null Hypothesis was rejected and concluded that there was a relation between the working time of mother with the success of exclusive breastfeeding. Mothers should breastfeed their babies exclusively from childbirth until six months by using the facilities of the breastfeeding room or by storing her breast milk in the refrigerator before going to work.

1. Introduction

Breastfeeding provides sufficient energy and nutrients for growth of the newborn baby in the first six months of their life. Breastfeeding contains many required substances that are essential for their growth and development. However, some mothers avoid breastfeeding their babies for the reason not to become fatty, to prevent their breasts from sagging and because of their busy schedule. On the contrary, some mothers face some problems while breastfeeding their babies. The common problems include low production of milk and many other things that can affect milk production (Suherni 2008).

The results of interviews with six mothers who had children 6-24 months old in Bergas Lor illage, Bourgas district on January 13, 2013, showed that four mothers had been breastfeeding their children, and two mothers stopped breastfeeding any longer. Among six mothers, three mothers had been working more than 8 hours, and three mothers had been working less than 8 hours. The three mothers who had been working more than 8 hours, two babies were exclusively breastfed, and one baby was not exclusively breastfed. There was only one baby that had been breastfeeding exclusively on mothers who had been working less than 8 hours because they did not have time and they had gone to work.

2. Methods

The design of this research used correlative study with cross-sectional approach. The population in this research was all mothers with children 7-12 months old in February 2013; there were 49 mothers. The sampling technique in this research used purposive sampling. The characteristics sampling of the population used inclusion and exclusion criteria. Inclusion criteria were working mothers; mothers had babies 7-12 months, and willing to be a respondent. Exclusion criteria were the address of respondents were not found, mothers with infectious diseases when breastfeed their babies, babies with the disease lactose intolerance substance. Based on the inclusion and exclusion criteria were established, the number of samples was 43 respondents — the research was conducted in Bergas Lor village, Bergas district on February 18th to 22th,2013. The data used secondary and primary data with a questionnaire that distributed directly to the respondents (door to door). The research ethics was informed consent, confidentiality, and anonymity. The stages of analyzing data in this study were editing, coding, and entering.

3. Results

In this research, the type of data used secondary and primary data. The data were analyzed by univariate and bivariate analysis.

Table 1

Frequency Distribution Based on Working Time of a Mother in Bergas Lor Village-Bergas District.

Working Time

Frequency

Percentage (%)

<8 hour/day

15

34.9

≥8 hour/day

28

65.1

Total

43

100.0

The results of research of 43 respondents there were 28 mothers (65.1%) mostly worked ≥8 hours/day, and 15 mothers (34.9%) worked <8 hours/day.

Table 2

Frequency Distribution Based on The Success of Exclusive Breastfeeding in Bergas Lor Village-Bergas District.

Exclusive Breastfeeding Success

Frequency

Percentage (%)

Unsuccessful

30

69.8

Successful

13

30.2

Total

43

100.0

The results of 43 respondents showed that there were 30 mothers (69.8%) unsuccessful, and 13 mothers (30.2%) mothers had been successful in exclusive breastfeeding.

Table 3

The Relation between Working Time of Mother With Exclusive Breastfeeding Success in Bergas Lor Village-Bergas District.

Working Time of Mother

Exclusive Breastfeeding Success

Total

X2

p-value

Unsuccessful

Successful

<8 hours/day

7

46.7

8

53.3

15

100.0

4.268

0.039

≥8 hours/day

23

82.1

5

17.9

28

100.0

Total

30

69.8

13

30.2

43

100.0

The results showed that from 15 mothers who worked < 8 hours/day, there were 7 mothers (46.7%) did not give exclusive breastfeeding to her baby, and there were 8 mothers (53.3 %) gave exclusive breastfeeding to her baby and 28 mothers who worked ≥8 hours/day, as many as 23 mothers (82.1%) did not provide an exclusive breastfeeding to her baby, and as many as 5 mothers (17.9%) gave exclusive breastfeeding to her baby.

4. Discussions

Regarding the economy during the approach by a researcher of the respondents in Bergas Lor village, Bergas district, it could be concluded that the majority of the people in the Bergas Lor village was a middle to the low class of the community. Many mothers who work outside the home help their families to earn money to supply their daily needs. Working time had been set from the workplace was something that must be adhered as a form of labor discipline. Each workplace has its own policy in determining the time of work for their employees. Working hours have been listed in the labor laws of Republic of Indonesia No. 13 Th. 2003 for employment. In chapter X, protection, wages, welfare, and working time, article 77 stated that: Every employer should implement the provisions of working time, working time referred to paragraph (1) include: 7 (seven) hours, 1 (one) day, and 40 (forty) hours, 1 (one) week, for six (6) working days within 1 (one) week or eight (8) hours, 1 (one) day, and 40 (forty) hours, 1 (one) week, for 5 (five) working days within 1 (one) week, working time provisions referred to paragraph (2) do not apply to certain business sectors, requirement concerning working time in the business sector or a particular job as related to (3) shall be regulated by ministerial decree. The coverage success of exclusive breastfeeding in Bergas Lor village, Bergas district was very low, that was 30.2%. It was still very far from the government's policy program to improve exclusive breastfeeding up to 80%. One of many reasons for the failure in exclusive breastfeeding in Bergas Lor Village was due to some financial needs, the mothers along with their husbands had to work outside for the better baby's life. As they had to work, they prefer to feed baby from bottle milk rather than their owns. The physical factors and motivation of the mother to give exclusive breastfeeding should be strong. Most of the mothers in the Bergas Lor Village said that they felt inadequate when only provide breastfeeding to their babies because of less breastfeeding that came out.

Saleha (2009) stated that production of milk would increase in mother breasts when baby sucked the breast because while sucking, the hyplothalamus released prolactin resulting in increasing the amount of milk. After question and answer session to the respondent, there was the absence of knowledge on the importance of exclusive breastfeeding and breast milk storage in Bergas Lor Village's mothers especially the ones working outside the home.

After question and answer with health officials at Health Clinics in Bourgas district and with respondents at the time of collecting data, the health service counseling program had been done in the community about exclusive breastfeeding in Bergas Lor village, Bourgas district. However, the effect of counseling did not meet the expectations yet. Saleha (2009) demanded promotion for several contributing factors necessary for breastfeeding including the role of health workers, hospitals and government roles, the part of mother physical, occupational factors, family factors, community factors, and baby factors.

The Chi-Square test results by Yates' Continuity Correction obtained X2 was 4.268 with p-value was 0.039. Because of p-value < α (0.05), Null Hypothesis was rejected and concluded that there was a relationship between the working time of a mother with the success of exclusive breastfeeding in Bergas Lor village, Bourgas district. Base on the data, some fewer mothers worked ≥ 8 hours/day were able gave exclusive breastfeeding to their babies than mothers who worked<8 hours/day. This had an impact on exclusive breastfeeding because of the reason that those mothers who worked outside had less time to stay at home and feed their babies.

Hulpaturohmi (2011) showed the status of the working associated with exclusive breastfeeding. According to Siregar (2004), the job was one of the big reasons for women who work outside the home could not exclusively breastfeed baby up to 6 months old but there was also a gap that not all women who worked < 8 hours/day had been giving exclusive breastfeeding successfully, and not all mothers worked ≥ 8 hours/day had been giving exclusive breastfeeding unsuccessfully. There were seven working mothers <8 hours/day who did not provide exclusive breastfeeding, most of them said that providing breastfeeding only was not enough for their babies. Also, there was an environmental and social effect on exclusive breastfeeding because some mothers felt that the extra food is better than milk for the infants. The five mothers that worked ≥ 8 hours/day that had been giving exclusive breastfeeding successfully to their babies, most of them said that the mother knew the importance of exclusive breastfeeding for baby up to 6 months by the instruction of health services in integrated health service post. They said that the ways to provide breastfeeding to their babies were by storing her breastfeeding in the refrigerator before going to work. So, it could be seen that knowledge, time, and energy in the success of exclusive breastfeeding program were needed.

WHO (1984) in Notoatmodjo (2005), stated that one of the four principal reasons people behave was resources, namely: facilities, money, time, energy, and so on. The impact of resources on behavior could be positive or negative.

5. Conclusions

Most of the mothers that had babies 7-12 months old, 28 of them (65.1%) worked ≥8 hours/day, and 15 of them (34.9%) worked <8 hours/day. Exclusive breastfeeding was mostly unsuccessful. There were 30 of unsuccessful mothers (69.8%) and 13 mothers (30.2%) had been successful. There was a relation between the working time of a mother and the success of exclusive breastfeeding with X2 value was 4.268 and p-value was 0.039. So, the interpretation was p-value <α (0.05).

Acknowledgments

Mrs. Puji Lestari, S.Kep., Kes (Epid), as the first mentor and Mrs. Sundari, S.SiT, as the second mentor that patiently provided encouragement, guidance, direction, and suggestions in the manufacture of paper to be completed. Mr. dr. Thomas Tryono, as the head of Health Clinics in Bourgas District, had allowed me to research Bergas Lor Village-Bourgas District. My family who always prays for me and motivates me, making me able to complete the preparation of this research. Friends that I could not mention them one by one also helped me so that I could finish the development of this research.

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